Term
| What is the function of the Frontal Lobe? |
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Definition
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Term
| What is the func. of Parietal Lobe |
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Definition
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Term
| Func. of the Temporal Lobe? |
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
| Cardiac, resp, vasomotor center |
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Term
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Definition
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Term
| What are the 3 layers of the Meninges? |
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Definition
| Dura, Arachnoid, Pia Mater |
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Term
| What is in between the Dura & Arachnoid? |
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Definition
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Term
| How much of the total C.O goes to Cerebral Circulation? |
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Definition
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Term
| What is the Circle of Willis? |
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Definition
| Where 2 corotid and Veteberal vessels come together at the base. Site of aneurisims and CVA |
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Term
| The Autonomic NS include what? |
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Definition
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Term
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Definition
| Brain, supporting structures, and spinal cord |
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Term
| SNS when stimulated lead to what physiological changes? |
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Definition
| INCREASE HR, INCREASE BP, vasoconstriction |
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Term
| PSNS when stimulated lead to what physiological changes? |
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Definition
| DECREASE HR, INCREASE Intestine peristalsis, INCREASE Glandular activity, relaxes sphincters |
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Term
| What test can be used to see structural damage? |
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Definition
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Term
What test is used for in emergencies?
To see what? |
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Definition
CAT Scan
To see vasculature
Could be performed w. or w/o contrast dye |
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Term
| What can MIR be used to look for? |
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Definition
| Too look at Arterial Flow |
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Term
| What can PET scan be used for? |
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Definition
| 1. Brain matabolism 2. Blood flow 3. O2 uptake 4. Glucose uptake |
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Term
What is cerebral angioram used to see?
What cautions you have to take? |
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Definition
Used to study cereberal circulation.
Cautions: Contrast dye may be allergic.
Do full neuro-check. After procedure check for neuro deficits |
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Term
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Definition
| Diagnose Seizures, Coma, determine brain death |
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Term
Describe Lumber Puncture:
What are they looking for? |
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Definition
Inserting a needle between L3 and L4 of subarachnoid space to extract CSF
Looking for bacteria, protein, cell counts, glucose |
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Term
What is used to monitor intercranial pressure?
What is normal Intercranial Pressure? |
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Definition
Monometer is used to check intercranial pressure.
Normal Intercranial pressure= 70-200 mmwater |
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Term
Why should you lay the patient flat after the procedure?
How to fix?
How to fix more severe case? |
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Definition
To avoid spinal headache.
Fix: Anogelsics, fluids, and rest.
For more severe case, give blood patch |
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Term
| What are complications of Lumbar Puncture? |
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Definition
| Headache, herniation of the cerebral contents (too much pressure is already inside, cause brain to drop), infection, hematoma |
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Term
| Definte "paresis" and "plegia" |
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Definition
Paresis means Motor weakness
"Plegia" means paralysis |
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Term
| One side of body weakness/paralysis? |
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Definition
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Term
| Both legs & the lower part of the trunk? |
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Definition
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Term
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Definition
| quadriparesis/quadriplegia |
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Term
| What is the term for loss of sensation? |
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Definition
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Term
| Neurological dysfunction could be caused from what 2 factors? |
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Definition
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Term
What are the structural causes?
They lead to the brain to do what? |
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Definition
Head injury, intracranial hemorrhage, encephalitis, brain abscess, & stroke
Cause brain to swell-->INCREASE intercranial pressure-->DeCREASE Cerebral Blood Flow |
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Term
| What are the metabolic causes? |
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Definition
| Sepsis, hypovolemia, MI, resp arrest, hypoglycemia, electrolyte imalance, drug & alcohol abuse, diabetic ketoacidosis, hepatic encephalopathy |
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Term
| Intracranial Pressure is a refection of what 3 relatively fixed volumes? |
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Definition
The brain, CSF, & Blood
Increase in one will lead to decrease in the other 2 as compensation mechanism |
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Term
| What can cause Increase Cranial Pressure? |
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Definition
| Increase in any of these: Brain volume, Blood Volume, CSF Volume |
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Term
How does Hypercapnia cause ICP?
How does Hypoxemia cause ICP? |
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Definition
PaCO2>45 will DECREASE resp rate
PaO2<50 will cause cereberal edema |
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Term
| What other contribute to ICP? |
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Definition
| Valsalva maneuver, positioning, Isometric muscle contractions, coughping, sneezing, emotional upset, Noxious stimuli, excesive sensory stimuli |
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Term
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Definition
| Oriented X 3, sleeps often, speech & thought slow |
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Term
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Definition
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Term
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Definition
| Sleep a lot, rousable, awake only w/ constant stimuli, follows simple commands |
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Term
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Definition
| Wakens to painful stimuli |
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Term
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Definition
| Does not respond to environmental stimuli |
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Term
| What is the FIRST THING that we see in someone with ICP? |
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Definition
| Change in Level of Conciousness or Behavior |
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Term
| What are other early pictures of ICP? |
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Definition
| Pupils, motor func, constant headache, VS (normal or a bit tachy), Visual disturbance |
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Term
| What are late signs of ICP? |
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Definition
| 1. LOC continues to detriorate 2. Loss of brain stem reflex (pupils fixd, no corneal reflex, loss gag & swallow reflex) |
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Term
What motor response do you see in late symptoms of ICP?
What is the worst prognosis? |
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Definition
| Flasid motor response is the WORST! |
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Term
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Definition
| Flexed towards the center |
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Term
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Definition
| Flexed outward arms extended |
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Term
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Definition
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Term
| What is the #1 Intervention for ICP? |
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Definition
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Term
| What are other interventions for ICP? |
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Definition
| Decrease cerebral edema, maintain cerebral perfusion, reduce CSF & blood Volume, control fever, reduce metabolic demands |
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Term
How do you decrease Cerebral Edema?
What kind of drug used? |
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Definition
Osmotic Diaretics (Mantatol)-->pull fluid from brain tissue intravascularly-->increase urinary output
Corticosteroid (Nethopromytholon) |
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Term
| How do u reduce CSF & Blood Volume? |
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Definition
| Draining off. Reduce blood volume by hyperventilating the patient-->to lower paCO2 to 30-34 for period of time. |
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Term
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Definition
| Antipyretics (acetometaphine), cooling blanket slowly without shiver, or use dose of Thorzine to stop shivering. |
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Term
| How to Reduce Metabolic Demands? |
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Definition
| Temporarily paralyze patient with Panceronium (non depolarization muscle locker) |
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Term
| How to maintain a patent airway for ICP? |
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Definition
Suction, hyperoxygenate prior to suctioning.
Do not use PEEP. Maintain straight airway and head of the bed to 30 degrees-->help improve cereberal venous return. |
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Term
Unconciousness =
Coma =
Persistent Vegetative State =
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Definition
Unconciousness= Unresponsive, unaware of environmental stimuli (last minutes to hours)
Coma = Unconciousness for days, months, years
Persistent Vegetative State = wakeful but no conscious or cognitive mental function |
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Term
| What are causes of unconsciousness & coma? |
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Definition
| 1. Neurological (structural) 2. Toxic (overdoses of exposures to toxin) 3. Metabolic |
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Term
| What are the Nursing Assessments of unconcious patient? |
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Definition
Airway Breathing Cirulation!
Skull x-rays, CT, MRI/MRA, EEG
Blood Work (CBC, electrolytes, ketones, Hydrogen, drug alcohol, ABG) |
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Term
What is the Glasgow Coma Scale?
When can this not be used? |
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Definition
Opening eyes, verbal, and motor response to test the Level of Conciousness. More you can do, the more points.
CAN'T be used for pts with intubation and anti motor drugs |
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Term
| What kind of respiration can you find in an unconscious patient? |
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Definition
| Cheyne-Stokes, Hyperventilation |
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Term
What to look for in pupils of unconcious pt?
PERRLA? Unequal? Dilating? |
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Definition
PERRLA- Toxic or metabolic
Unequal- Localized Neural problem
Fixd & Dilated- ICP or brain injury |
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Term
| What to look for in Corneal Reflex? |
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Definition
| Blink is normal. Unilateral-Local. Absent-Deep coma |
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Term
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Definition
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Term
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Definition
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Term
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Definition
| Stiff = subarachnoid heme, meningitis |
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Term
| When apply firm pressure on sternum, if no reaction, what is going on? |
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Definition
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Term
| Posters: Decorticate? Decerebrate? Flaccid? |
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Definition
| Decorticate-Cerebral hemisphere midbrain. Decerebrate-Lower brain stem. Flaccid-Neuro or Metabolic |
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Term
What is a negative Babinski?
Positive Babinski? |
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Definition
When toes curl.
When toes dorsiflex, especially great toe |
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Term
| Nursing diagnosis & goals for Unconcious Patient |
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Definition
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Term
| What are the top risk factors for CVD? |
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Definition
| Cardiovascular Disease, HTN, DM, Smoking, Family HX of CVA, Sedentary lifestyle |
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Term
| What is Transient Ischemic Attack (TIA)? |
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Definition
| Temporary episode of neurological dysfunction with sudden loss of motor, sensory, or visual func. |
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Term
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Definition
| Ausultate Corotid for Brui or diminished flow, Carotid Doppler Study, Carotid angiogram |
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Term
| What procedures are there to correct TIA? |
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Definition
| 1. Carotid angioplasty 2. Surgcal carotid Endarterectomy (CEA) 3. Anticoagulation treatment |
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Term
| On the Stroke (CVA) risk card, what score is dangerous? |
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Definition
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Term
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Definition
F=FACE (ask the person to smile. Does one side of the face droop?)
A= ARM Ask person to raise both arms. Does one arm drift downward?
S=SPEECH Ask the person to repeat a simple phrase. Does the speech sound slurred or strange?
T= TIME If you observe any of these signs, CALL 911! |
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Term
| What are Embolic or Thrombotic Occlusion Risk Factors? |
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Definition
| Arteriosclerosis, atrial fibrillation, diesease of heart valves |
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Term
| What are risk factors for Hemorrphagic CVA? |
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Definition
Hemorrhagic: Rupture of cerebral vessel
Risk factors: Uncontrolled HTN, trauma, arteriovenous malformation, intracranial aneurysms |
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Term
| What tests are done to diagnose stroke? |
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Definition
| CT, Carotid Doppler or cerebral angiogram |
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Term
What is Neurodeficit of CVA for Visual Field?
Define Hemianopsia & Diplopia |
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Definition
| Hemianopsia- Lose half of visual field, Loss of peripheral vision, Diplopia-Double vision |
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Term
Motor?
Define Ataxia, Dysarthria, Dysphagia |
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Definition
| Hemiparesis, Hemiplegia, Ataxia-steady gait, Dysarthria-difficulty forming words, Dysphagia-difficult swallow |
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Term
Sensory?
Define Paresthesias? |
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Definition
Paresthesias-numb or tingling
Difficulty w. Proprioception-Space orientation |
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Term
Verbal?
Define Expressive, Receptive, Global |
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Definition
| Expressive-Can't express, Receptive- can't understand, Globa- when both happens |
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Term
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Definition
| Memory loss, decrease attention span, can't concentrate, poor reasoning, altered judgment |
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Term
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Definition
| Loss of self-control, emotional lability, decrease tolerance to stress, depression, withdrawl, feeling of isolation, fear, hostility, anger |
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Term
| Describe Left Hemisphere CVA symptoms: |
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Definition
| Right paralysis or paresis, RT visual field deficit, Rt Aphasia, Altered intellectual ability, Slow cautious behavior |
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Term
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Definition
| LT paralysis or paresis, LT visual field deficit, Spatial-perceptual deficits, very distractible, Impulsive behavior & poor judgment, lack of awarenss of deficits |
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Term
| What are medical treatments for Ischemic Stroke? |
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Definition
| Thrombolytic Therapy, anticoagulants |
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Term
| Treatments for Hemorrhagic Stroke? |
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Definition
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Term
| What are complications from CVA and how to prevent them? |
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Definition
| Cerebral Hypoxia (oxygenation, H&H WNL), Decreased Cerebral Blood Flow (BP & CO WNL, adequte hydration), Extension of the area of Injury (avoid hypo or hypertension) |
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Term
| Pre-op care for Craniotomy? |
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Definition
| Baseline neurological assessment, Prepare client & family for postoperative appearance, teaching, allow questions, consent for surgery |
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Term
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Definition
| Antiseptic shampoo, anticonvulsant meds, reduce cerebral edema, prevent infection, pre-op sedation |
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Term
| What are complications from Crainiotomy? |
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Definition
| ICP, bleeding, Fluid & electrolyte imbalances, infection, seizures |
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